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Monday, April 07, 2008

Monthly self-examinations urged

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By SARA ARTHURS

Staff Writer

Breast self-examination should be done after the end of a woman's menstrual period. Some experts recommend seven to 10 days afterwards; others recommend immediately afterwards.

The important thing is to do it after a woman's period ends, rather than before it starts, because hormones involved in menstruation can affect what a woman finds in her breast, said Blanchard Valley Hospital breast health nurse Debra Kuhlman.

Women no longer menstruating should simply perform the exam at the same time every month.

The Susan G. Komen Breast Cancer Foundation offers the following self-examination tips for women:

• Lie down on your back with a pillow under your right shoulder.

• Check your right breast with the pads of the three middle fingers on your left hand.

• Use light, then medium, then firm, pressure. Press in a circle without lifting your fingers.

• Feel for changes in your breast, above and below your collarbone and in your armpit.

• Repeat on your left breast.

• In front of a mirror, inspect your breasts in four steps: Holding your arms at your side, holding your arms over your head, pressing your hands on your hips and tightening your chest muscles, and bending forward with your hands on your hips.

It is particularly important to include the upper quadrant of the breast near the armpit, Kuhlman said, since a large number of cancers are found there.

The American Cancer Society recommends: "Move your fingers in a circular motion until the entire breast has been examined from the armpit to the shoulder, along the collarbone, down the sternum and under the breast. Switch hands and repeat this process with the other breast."

Kuhlman said experts also recommend women "stand in front of a mirror and just look at your breasts."

Warning signs to look for, according to the Komen Foundation, are:

• A lump, hard knot or thickening.

• Swelling, warmth, redness or darkening.

• A change in the size or shape of the breast.

• Dimpling or puckering of the skin.

• An itchy, scaly sore or rash on the nipple.

• Pulling in of the nipple or other parts.

• A nipple discharge that starts suddenly.

• A new pain in one spot that does not go away.

Kuhlman and colleague Barbara Deerwester have a model of a breast in their office and teach women how to do self-exams by practicing on it. The two are "nurse navigators," helping patients with breast cancer or breast health concerns navigate their way through the health care system.

Experts say don't panic over a lump or two because most breasts include some lumps and most lumps are not cancer.

But Kuhlman said it is important to get the lump checked. A self-exam every month ensures that women will be familiar with their breasts and aware of any changes, she said.

Using light, medium, and firm pressure ensures women will feel things in different parts of the breast, Kuhlman said.

Women should start doing breast self-exams at age 20.

Pregnancy creates changes in a woman's breasts, and it's important to pay attention to them, Kuhlman said.

"Women who are pregnant and breast feeding should continue doing their monthly breast exam," she said.

Breast self-exams help women catch tumors while they're still small, offering the best chances for survival, Kuhlman said.

Also, Kuhlman said annual mammograms and clinical breast exams from a doctor or nurse practitioner are just as important. Together, the three are the best way to ensure early detection of cancer.

Mammograms can find tumors not detectable through a self-exam. Also, the Komen Foundation recommends women get clinical breast exams every three years starting at age 20 and annually after age 40.

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